Comprehensive Guide on CPT Codes for Gynecology

CPT Codes for Gynecology

Current Procedural Terminology CPT codes for gynecology are classified into several categories based on the type of procedure performed. It’s divided in main categories as Evaluation and Management (E/M) codes; surgery codes; radiology codes; laboratory/pathology codes; and medicine codes. These codes cover a wide range of services related to gynecology care, including diagnostic procedures, surgeries, and other treatments. We shared commonly used CPT codes under these main categories.

Providing a complete list of CPT codes for gynecology is not possible due to copyright constraints. Note that the American Medical Association (AMA) holds the copyright for Current Procedural Terminology (CPT) codes. If you are looking for coding and billing assistance for gynecology or OB/GYN then email us at: info@medicalbillersandcoders.com or call us at: 888-357-3226.

Categories of CPT Codes for Gynecology:

1. Evaluation and Management (E/M) Codes

Categories of CPT Codes for Gynecology

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Evaluation and Management (E/M) codes are used by healthcare providers to report and bill for office visits and other outpatient services. In gynecology, these codes are used to document and report services related to the evaluation and management of women's reproductive health.

Following are some common E/M codes used in gynecology:

  • 99202-99215: These codes are used to bill for office visits, ranging from a brief problem-focused visit to a comprehensive visit. These codes take into account factors such as the complexity of the patient's medical history and the level of medical decision-making required.
  • 99384-99387: These codes are used for annual wellness visits for new patients, ranging from a comprehensive preventive evaluation and management of an individual, including an age and gender-appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate laboratory/diagnostic procedures, new patient; 18-39 years old, including counseling/anticipatory guidance/risk factor reduction interventions.
  • 99394-99397: These codes are used for annual wellness visits for established patients, ranging from a comprehensive preventive evaluation and management of an individual, including an age and gender-appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate laboratory/diagnostic procedures, established patient; 18-39 years old, including counseling/anticipatory guidance/risk factor reduction interventions.
  • 99401-99404: These codes are used to bill for preventive counseling and risk factor reduction interventions, such as contraceptive counseling or counseling for sexually transmitted infections.
  • 81025: This code is used for a urine pregnancy test.
  • 88164-88167: These codes are used for cervical cancer screening tests, such as a Pap smear.

The specific E/M codes used will depend on the individual patient's circumstances and the services provided during the visit. It's also important to ensure accurate and appropriate documentation to support the use of these codes.

2. Surgery Codes

Surgery codes are used for surgical procedures, such as hysterectomies, laparoscopies, and dilation and curettage (D&C) procedures. They are categorized based on the type of procedure and the approach used, such as vaginal or abdominal.

Following are some examples of surgery procedure codes related to gynecology:

  • Hysterectomy: CPT code 58150. This code is used for a total abdominal hysterectomy, including the removal of the uterus and cervix.
  • Laparoscopic hysterectomy: CPT code 58570. This code is used for a laparoscopic total hysterectomy, including the removal of the uterus and cervix.
  • Oophorectomy: CPT code 58956. This code is used for a unilateral (one side) oophorectomy, which is the surgical removal of an ovary.
  • Salpingectomy: CPT code 58700. This code is used for the surgical removal of one or both fallopian tubes.
  • Endometrial ablation: CPT code 58353. This code is used for the destruction of the uterine lining (endometrium) using various techniques, such as thermal ablation or radiofrequency.
  • Myomectomy: CPT code 58140. This code is used for the surgical removal of uterine fibroids.
  • Cervical biopsy: CPT code 57421. This code is used for the removal of a small amount of tissue from the cervix for examination.

These are just a few examples of the surgery procedure codes related to gynecology. There are many more codes for other procedures, such as colposcopy, dilation and curettage, and pelvic reconstructive surgery, among others.

3. Radiology Codes

Radiology Codes

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Radiology codes are used for imaging studies, such as ultrasounds and mammograms. They are categorized based on the type of imaging study and the area of the body being studied.

Common radiology codes related to gynecology include:

  • Transvaginal Ultrasound (76830): This code is used to describe an ultrasound exam of the female pelvis, including the uterus, cervix, and ovaries. It is commonly used to evaluate conditions such as uterine fibroids, ovarian cysts, and endometrial cancer.
  • Hysterosalpingography (74740): This code is used to describe an X-ray procedure that evaluates the uterus and fallopian tubes. It involves the injection of a contrast dye into the uterus, followed by X-ray imaging to evaluate the flow of the dye through the reproductive tract. This procedure is commonly used to evaluate infertility and to diagnose conditions such as blocked fallopian tubes.
  • Magnetic Resonance Imaging (MRI) Pelvis (72195): This code is used to describe an MRI scan of the pelvis, including the reproductive organs. It is commonly used to evaluate conditions such as ovarian cancer, endometriosis, and pelvic inflammatory disease.
  • Computed Tomography (CT) Pelvis (72193): This code is used to describe a CT scan of the pelvis, including the reproductive organs. It is commonly used to evaluate conditions such as ovarian cancer, uterine fibroids, and pelvic inflammatory disease.

These are just a few examples of radiology procedure codes related to gynecology. There are many others that may be used depending on the specific imaging study and condition being evaluated.

4. Laboratory/Pathology Codes

Laboratory/pathology codes are used for laboratory tests and pathology studies, such as pap smears and biopsies. They are categorized based on the type of test or study being performed.

Following are some common laboratory/pathology procedure codes related to gynecology:

  • Pap smear (88141, 88142, and 88143): These codes are used to report the collection and interpretation of cervical or vaginal smears for the detection of abnormal cells.
  • HPV testing (87624, 87625): These codes are used to report the testing for the human papillomavirus (HPV) in women.
  • Chlamydia and Gonorrhea testing (87491, 87591, 87850, and 87800): These codes are used to report the testing for sexually transmitted infections (STIs) chlamydia and gonorrhea.
  • Pelvic ultrasound (76856): This code is used to report an ultrasound examination of the female pelvic region, including the uterus, ovaries, and fallopian tubes.
  • Endometrial biopsy (58100, 58110, and 58120): These codes are used to report the collection and interpretation of a sample of tissue from the lining of the uterus for diagnostic purposes.
  • Hysteroscopy (58555, and 58558): These codes are used to report a diagnostic or surgical procedure that involves inserting a thin, lighted tube through the vagina and cervix to examine the uterus.

It's important to note that these codes may vary depending on the specific tests or procedures performed and the payer requirements.

5. Medicine Codes

Medicine Codes

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Medical procedures related to gynecology can include diagnostic tests, surgeries, and other interventions. These procedures are often assigned a specific code for billing and record-keeping purposes.

Here are some examples of medicine procedure codes related to gynecology:

  • 57420: Colposcopy of the cervix, including biopsy of the cervix or endocervical curettage
  • 58300: Insertion of intrauterine device (IUD)
  • 58301: Removal of the intrauterine device (IUD)
  • 58661: Laparoscopy, surgical; with the removal of adnexal structures (including tubes or ovaries)
  • 58563: Hysteroscopy, surgical; with the removal of leiomyomata (fibroids)
  • 58605: Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method
  • 58558: Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D&C
  • 58555: Hysteroscopy, surgical; with the removal of impacted foreign body
  • 58970: Fetal monitoring, non-stress test
  • 57454: Colposcopy of the vulva; with biopsy
  • 57460: Colposcopy of the vulva; with destruction of lesion(s) by any method

It's important to note that these codes may vary depending on the specific procedure, the location, and the individual patient's needs.

You will required certified and experienced coder for accurate use of CPT codes for gynecology. Note that the American Medical Association (AMA) updates the CPT codes annually, so the categories and codes may change over time. Additionally, insurance companies may have their own coding systems and guidelines for reimbursement. It's always a good idea to check with the insurance company to confirm which codes are appropriate for your specific situation.

Medical Billers and Coders (MBC) is a leading revenue cycle management company providing complete medical billing and coding services. We understand the unique needs of OB/GYN practices and provide tailored billing services to meet your specific requirements. We have a team of experienced coders and billers who are trained in OB/GYN coding, billing, denial management and accounts receivable. Our OB/GYN billing services include everything from claims submission, and denial management to patient billing and even provider credentialing.

We have a proven track record of success and a commitment to providing high-quality services that meet the unique needs of each practice. To know more about our OB/GYN billing and coding services, email us at: info@medicalbillersandcoders.com or call us at: 888-357-3226.


Published By - Medical Billers and Coders
Published Date - Mar-28-2023 Back

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